02/11/2024
Still thinking about what a complete and thorough dental examination might involve? Well here we go!
We want to make sure no problems go unseen. So the closer we LOOK and FEEL and SMELL and use all the senses… ok maybe not taste but no judgement (ok I’m judging that’s gross) the more we will FIND. When we are set up for success to find all the information we need… the better prepared we are to do something about it and help your horse. That there is the goal! We want to keep your horses comfortable, with as many functional teeth in their mouth for as long as possible.
The only way to do this is to examine and examine often and catch things when they are minor. Therefore it is recommended to examine the health of their oral cavity at least every 6-12 months. As with everything it’s way easier to prevent than treat so please consider your horses oral care as part of your preventative/ routine medical care.
At every dental visit we want to touch on 5 important things.
We start off with a comprehensive History and Physical exam. This is where we might catch any signs of dental disease that you may have not considered. But it also makes us aware of any other health concerns that could be playing a role or need to be considered once we start making a treatment plan.
Then we sedate the patient. Now hear me out. I know many get worried here. But stick with me.
While your horse is relaxing we do our external examination. We are looking for facial symmetry, any hard or soft lumps or bumps, old injuries, anatomy in general, discharge or odor from the nostrils?
Now, we can look at their incisors and canines as part of our rostral oral exam. All done before placement of our speculum. We are looking at the soft tissues and surrounding structures, the gums/gingiva, the teeth themselves and what we call the endodontic status, that’s assessing the live portion of the tooth within the tooth itself. The periodontal status is assessing around or the outer portion of the tooth. Just like us horses get gingivitis and periodontal disease too!
Now, we can place our speculum and can start our caudal (back) or part of our oral exam. We may have already checked the bars of their mouth for any lumps or bumps or damage while they were getting sleepy.
Just like our rostral exam, we are looking at all our soft tissues, tongue, cheeks, palate etc. We are looking at every tooth and every aspect of it on all sides. We are looking at both the periodontal health and endodontic health just as we did with the incisors. We are looking for signs of abnormal wear, fractures, missing teeth, loose teeth. The list goes on.
For this to all happen. We need a very still, relaxed, and compliant horse. This is where the sedation is very important. We don’t want them worried, we want them calm and comfortable. This keeps them from hurting themselves or us and allows us to get our job done and done well. We (veterinarians) are all type A so we want do this right and well! We take our time, using a very bright light (we are looking into a dark cave essentially) while also using a mirror. This mirror we use to view each side of every single tooth alllll the way to the back. If there is food still packed in places we rinse and use picks and probes to remove it so we can better assess any problems beneath, taking any measurements if there are pockets between or around the teeth. The occlusal or grinding surface of the tooth is inspected very carefully to make sure no areas of the live portion of the tooth (pulp horns) are exposed. For this we use an explorer just like at our dentist! We make sure our explorer glides over these structures like glass, noting any spots where we may get caught up or stuck. These are very very subtle findings many times.
Many times, we can get an even closer look by using our endoscope or oral camera which is a great way to get to tricky places and magnify what we are looking at.
We take all our pictures, and make all our notes on an organized dental chart.
Now, we can discuss any further diagnostics, based on our oral exam findings, and start formulating a treatment plan.
Whoa sounds like a lot! It sure is, but taking the time to do this 1-2 times per year could save your horse a lifetime of difficulties and your bank account a lifetime of debits!
Plus. A horse with fully functional dentition will continue to grind their hay efficiently, getting more nutrition out of it (read that as less hay waste $$$ and a healthy horse) they will have decreased risk of choke or impactions, they may even shed less water in their f***s too (less scrubbing butts and tails!)
The pictures below are to demonstrate the difference between not having a bright light, a nice wide open mouth with a bright light, the information you can gain by simply removing the feed packing, then introducing a mirror. Once you take these steps, you clearly see this horse was packing feed due to a fractured tooth and needs much more than just a float. This horse needs further diagnostics to assess that tooth better and determine if it should be extracted or can be monitored. More on that later!
There is also an example of the first page of our dental chart. All of our notes go right here and into their files.
So far… dentistry in horses is WAY more than just a float!
So, where do we go from here? What are some of the fun things we might find in there?
